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C-Section Delivery

What happens during a C-section delivery?

During this procedure, an OB/GYN surgically removes the baby from your uterus through a low incision just above your pubic bone. This is a major abdominal surgery, so you would receive anesthesia, usually through an epidural or spinal block. The medication leaves you awake and alert, yet feeling no pain. You may feel some pressure or tugging, though. In some rare emergency cases, your doctor might order a general anesthetic.

Sometimes a C-section is planned. If your baby is in the breech (bottom first) position, you’re carrying twins, triplets or more, or the placenta is blocking or too close to the cervix, your OB may schedule a C-section. You’ll arrive at the hospital one to two hours before your surgery time, so you can fill out paperwork and have your blood drawn.

Other times C-sections are not planned. If, during the course of labor, the baby appears too big to pass through your pelvis, labor is not progressing as it should, or the baby is showing signs of distress, your doctor may decide that a C-section is the best course of action. Scheduled C-sections are performed in the operating rooms on the labor and delivery unit at First Hill, Edmonds and Issaquah, and in the main OR in Ballard.

A C-section usually takes about an hour, from start to finish. Your baby will be born within the first 15 minutes; the rest of the time is spent closing up the incision. You may have one other person in the room with you during the operation. As soon as your baby is born, you’re welcome to hold her and get to know her while your surgery is completed.

What about C-Sections and VBACs?

In the video below Dr. Dorcas McLennan, Medical Director of the Family Childbirth Center at Swedish Ballard, discusses c-sections and VBACs (vaginal birth after cesarean section) including who might be a good candidate for a VBAC.

Afterward, you’ll be taken to a labor room to recover. You’ll have time to cuddle and breastfeed your baby, and for the first two hours nurses will closely check on your pulse, respiration, blood pressure, incision, uterus and bleeding. Once all your signs are stable, you’ll be moved to a postpartum room.

It’s important to change positions often — at least every two hours — as is the case with any major surgery. Your nurses can help show you how. They’ll also encourage you to get out of bed and walk around your room a bit, as moving helps speed your recovery and prevent complications. You may feel a slight pulling at your incision as you move; this is normal and will go away in time. For the first 12 hours, you’ll receive pain medication through your IV. After that, you’ll receive oral pain medication.

Your incision will usually have metal staples or clips holding the skin together and will be covered by an adhesive bandage. On the second or third day, your nurse will remove the staples and apply small pieces of tape, called steri-strips. These will gradually loosen and fall off in the coming days. Getting your incision area wet during this time is not a problem — just be sure to dry it thoroughly afterward. Once home, if you notice any redness around the incision, see any oozing or drainage, or have any pain or swelling, call your doctor.

Full video text/transcript for "What about C-Sections and VBACs?" video

The way I look at C-sections, this is a tool in our toolkit to get a safe delivery of a healthy baby and a healthy mom. I think when it really comes down to it, the point is, we all want a healthy outcome for both parties, we have 2 patients we're taking care of.

The providers at Swedish have a very appropriate C-section rate. You have to remember a tertiary care center is going to have a slightly higher C-section rate because they deal with the highest risk patients. So when you look at Ballard and it's slightlly lower, it's not magic. It's just the reality of a moderate and low-risk group of patients being delivered at a community hospital in an urban setting as opposed to a tertiary care center. But even at Swedish First Hill, the rate is about the same as it is nationally.

VBAC, otherwise know as vaginal birth after cesarean, is widely practiced in the Swedish system currently. So now we are able to take care of women who really do want a trial labor after cesarean.

If you've had 2 or fewer cesarean sections and are otherwise a good candidate you can try for a trial of labor although there are of course caveats to that and of course there's a list of things that make you a less optimal candidate and ones that make you a better candidate and it probably depends a lot on why you had your first c-section, what the circumstance was, what your current circumstance is, how healthy are you and a variety of other things.

So, throughout the system, VBACs are offered and there may be some cases the community or suburban hospital think that if you want a VBAC you might be best served at First Hill, but in most cases we're able to manage those out in the community and suburban hospitals.

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